tailieunhanh - Báo cáo y học: "Effects of positive end-expiratory pressure on gastric mucosal perfusion in acute respiratory distress syndrome"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Effects of positive end-expiratory pressure on gastric mucosal perfusion in acute respiratory distress syndrome. | Available online http content 8 5 R306 Research Effects of positive end-expiratory pressure on gastric mucosal perfusion in acute respiratory distress syndrome Alejandro Bruhn Glenn Hernandez Guillermo Bugedo and Luis Castillo Open Access Programa de Medicina Intensiva Facultad de Medicina Pontificia Universidad Católica de Chile Santiago Chile Corresponding author Alejandro Bruhn abruhn@ Received 17 March 2004 Revisions requested 20 April 2004 Revisions received 1 9 May 2004 Accepted 10 June 2004 Published 15 July 2004 Critical Care 2004 8 R306-R311 DOI cc2905 This article is online at http content 8 5 R306 2004 Bruhn et al. licensee BioMed Central Ltd. This is an Open Access article verbatim copying and redistribution of this article are permitted in all media for any purpose provided this notice is preserved along with the article s original URL. Abstract Introduction Positive end-expiratory pressure PEEP improves oxygenation and can prevent ventilator-induced lung injury in patients with acute respiratory distress syndrome ARDS . Nevertheless PEEP can also induce detrimental effects by its influence on the cardiovascular system. The purpose of this study was to assess the effects of PEEP on gastric mucosal perfusion while applying a protective ventilatory strategy in patients with ARDS. Methods Eight patients were included. A pressure-volume curve was traced and ideal PEEP defined as lower inflection point 2 cmH2O was determined. Gastric tonometry was measured continuously Tonocap . After baseline measurements 10 15 and 20 cmH2O PEEP and ideal PEEP were applied for 30 min each. By the end of each period hemodynamic CO2 gap gastric minus arterial partial pressures and ventilatory measurements were performed. Results PEEP had no effect on CO2 gap median range baseline 19 2-30 mmHg PEEP 10 19 0-40 mmHg PEEP 15 18 0-39 mmHg PEEP 20 17 4-39 mmHg ideal PEEP 19 9-39 mmHg P . Cardiac index also remained unchanged baseline